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General NPI Number Information
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NPI Number | 1316930589
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Entity Type | Organization
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Legal Business Name | SOUTHERN HILLS NURSING CENTER INC
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5170 S VANDALIA AVE
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City | TULSA
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State | OK
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Zip | 74135-4079
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Country | US
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Telephone | 918-496-3963
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Fax | 918-496-0774
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Provider Business Mailing Address
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Address Line | 3073 HORSESHOE DR S STE 102
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City | NAPLES
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State | FL
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Zip | 34104-6144
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Country | US
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Telephone | 239-963-3400
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Fax | 239-963-3401
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Authorized Official
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Title or Position | VP
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Name | MR. THOMAS E RAWLES JR.
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Credential |
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Telephone | 239-659-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH72277227
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License Number State | OK
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